Healthcare Provider Details

I. General information

NPI: 1033847876
Provider Name (Legal Business Name): PAL MED LABS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 SATELLITE BLVD BLDG 400 STE 300
DULUTH GA
30096-8688
US

IV. Provider business mailing address

3235 SATELLITE BLVD BLDG 400 STE 300
DULUTH GA
30096-8688
US

V. Phone/Fax

Practice location:
  • Phone: 682-308-7373
  • Fax:
Mailing address:
  • Phone: 682-308-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MINHAJUDDIN MOHAMMED
Title or Position: PRESIDENT
Credential:
Phone: 682-308-7373